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Russell CA, Fouchier RAM, Ghaswalla P, Park Y, Vicic N, Ananworanich J, Nachbagauer R, Rudin D. Seasonal influenza vaccine performance and the potential benefits of mRNA vaccines. Hum Vaccin Immunother 2024; 20:2336357. [PMID: 38619079 PMCID: PMC11020595 DOI: 10.1080/21645515.2024.2336357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/26/2024] [Indexed: 04/16/2024] Open
Abstract
Influenza remains a public health threat, partly due to suboptimal effectiveness of vaccines. One factor impacting vaccine effectiveness is strain mismatch, occurring when vaccines no longer match circulating strains due to antigenic drift or the incorporation of inadvertent (eg, egg-adaptive) mutations during vaccine manufacturing. In this review, we summarize the evidence for antigenic drift of circulating viruses and/or egg-adaptive mutations occurring in vaccine strains during the 2011-2020 influenza seasons. Evidence suggests that antigenic drift led to vaccine mismatch during four seasons and that egg-adaptive mutations caused vaccine mismatch during six seasons. These findings highlight the need for alternative vaccine development platforms. Recently, vaccines based on mRNA technology have demonstrated efficacy against SARS-CoV-2 and respiratory syncytial virus and are under clinical evaluation for seasonal influenza. We discuss the potential for mRNA vaccines to address strain mismatch, as well as new multi-component strategies using the mRNA platform to improve vaccine effectiveness.
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Affiliation(s)
- Colin A. Russell
- Department of Medical Microbiology & Infection Prevention, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Ron A. M. Fouchier
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
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2
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Maurel M, Mazagatos C, Goerlitz L, Oroszi B, Hooiveld M, Machado A, Domegan L, Ilić M, Popescu R, Sève N, Martínez-Baz I, Larrauri A, Buda S, Túri G, Meijer A, Gomez V, O'Donnell J, Mlinarić I, Timnea O, Diez AO, Dürrwald R, Horváth JK, Dijkstra F, Rodrigues AP, McKenna A, Filipović SK, Lazar M, Kaczmarek M, Bacci S, Kissling E. Exploring the effect of clinical case definitions on influenza vaccine effectiveness estimation at primary care level: Results from the end-of-season 2022-23 VEBIS multicentre study in Europe. Vaccine 2024; 42:3547-3554. [PMID: 38704257 PMCID: PMC11152456 DOI: 10.1016/j.vaccine.2024.04.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 04/03/2024] [Accepted: 04/21/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Within influenza vaccine effectiveness (VE) studies at primary care level with a laboratory-confirmed outcome, clinical case definitions for recruitment of patients can vary. We used the 2022-23 VEBIS primary care European multicentre study end-of-season data to evaluate whether the clinical case definition affected IVE estimates. METHODS We estimated VE using a multicentre test-negative case-control design. We measured VE against any influenza and influenza (sub)types, by age group (0-14, 15-64, ≥65 years) and by influenza vaccine target group, using logistic regression. We estimated IVE among patients meeting the European Union (EU) acute respiratory infection (ARI) case definition and among those meeting the EU influenza-like illness (ILI) case definition, including only sites providing information on specific symptoms and recruiting patients using an ARI case definition (as the EU ILI case definition is a subset of the EU ARI one). RESULTS We included 24 319 patients meeting the EU ARI case definition, of whom 21 804 patients (90 %) meet the EU ILI case definition, for the overall pooled VE analysis against any influenza. The overall and influenza (sub)type-specific VE varied by ≤2 % between EU ILI and EU ARI populations. DISCUSSION Among all analyses, we found similar VE estimates between the EU ILI and EU ARI populations, with few (10%) additional non-ILI ARI patients recruited. These results indicate that VE in the 2022-23 influenza season was not affected by use of a different clinical case definition for recruitment, although we recommend investigating whether this holds true for next seasons.
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Affiliation(s)
| | - Clara Mazagatos
- National Centre of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
| | - Luise Goerlitz
- Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Robert Koch Institute, Berlin, Germany
| | - Beatrix Oroszi
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | | | - Ausenda Machado
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Lisa Domegan
- HSE-Health Protection Surveillance Centre, Dublin, Ireland
| | - Maja Ilić
- Croatian Institute of Public Health, Zagreb, Croatia
| | | | - Noémie Sève
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | | | - Amparo Larrauri
- National Centre of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
| | - Silke Buda
- Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Robert Koch Institute, Berlin, Germany
| | - Gergő Túri
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Verónica Gomez
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Joan O'Donnell
- HSE-Health Protection Surveillance Centre, Dublin, Ireland
| | - Ivan Mlinarić
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Olivia Timnea
- "Cantacuzino" National Military Medical Institute for Research and Development, Bucharest, Romania
| | - Ana Ordax Diez
- Instituto de Estudios de Ciencias de la Salud de Castilla y León (IECSCYL). Consejería de Sanidad. Junta de Castilla y León, Valladolid, Spain
| | - Ralf Dürrwald
- National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
| | - Judit Krisztina Horváth
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Frederika Dijkstra
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Adele McKenna
- HSE-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Mihaela Lazar
- "Cantacuzino" National Military Medical Institute for Research and Development, Bucharest, Romania
| | - Marlena Kaczmarek
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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3
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Skowronski DM, Zhan Y, Kaweski SE, Sabaiduc S, Khalid A, Olsha R, Carazo S, Dickinson JA, Mather RG, Charest H, Jassem AN, Levade I, Hasso M, Zelyas N, Gao R, Bastien N. 2023/24 mid-season influenza and Omicron XBB.1.5 vaccine effectiveness estimates from the Canadian Sentinel Practitioner Surveillance Network (SPSN). Euro Surveill 2024; 29:2400076. [PMID: 38362622 PMCID: PMC10986657 DOI: 10.2807/1560-7917.es.2024.29.7.2400076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 02/14/2024] [Indexed: 02/17/2024] Open
Abstract
The Canadian Sentinel Practitioner Surveillance Network reports mid-season 2023/24 influenza vaccine effectiveness (VE) of 63% (95% CI: 51-72) against influenza A(H1N1)pdm09, lower for clade 5a.2a.1 (56%; 95% CI: 33-71) than clade 5a.2a (67%; 95% CI: 48-80), and lowest against influenza A(H3N2) (40%; 95% CI: 5-61). The Omicron XBB.1.5 vaccine protected comparably well, with VE of 47% (95% CI: 21-65) against medically attended COVID-19, higher among people reporting a prior confirmed SARS-CoV-2 infection at 67% (95% CI: 28-85).
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Affiliation(s)
- Danuta M Skowronski
- British Columbia Centre for Disease Control, Vancouver, Canada
- University of British Columbia, Vancouver, Canada
| | - Yuping Zhan
- British Columbia Centre for Disease Control, Vancouver, Canada
| | | | - Suzana Sabaiduc
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Ayisha Khalid
- British Columbia Centre for Disease Control, Vancouver, Canada
| | | | - Sara Carazo
- Institut National de Santé Publique du Québec, Québec, Canada
| | | | - Richard G Mather
- Public Health Ontario, Toronto, Canada
- Queen's University, Kingston, Canada
| | - Hugues Charest
- Institut National de Santé Publique du Québec, Québec, Canada
| | - Agatha N Jassem
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Inès Levade
- Institut National de Santé Publique du Québec, Québec, Canada
| | | | - Nathan Zelyas
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Canada
| | - Ruimin Gao
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
| | - Nathalie Bastien
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
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4
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Smolarchuk C, Ickert C, Zelyas N, Kwong JC, Buchan SA. Early influenza vaccine effectiveness estimates using routinely collected data, Alberta, Canada, 2023/24 season. Euro Surveill 2024; 29:2300709. [PMID: 38214082 PMCID: PMC10785209 DOI: 10.2807/1560-7917.es.2024.29.2.2300709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 01/10/2024] [Indexed: 01/13/2024] Open
Abstract
Timely and precise influenza vaccine effectiveness (VE) estimates are needed to guide public health messaging and impact vaccine uptake immediately. Using routinely collected laboratory, vaccination and health administrative data from Alberta, Canada, we estimated influenza VE against infection for the 2023/24 season on a near real-time basis, to late December, at 61% (95% CI: 58-64) against influenza A(H1N1), 49% (95% CI: 28-63) against influenza A(H3N2) and 75% (95% CI: 58-85) against influenza B.
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Affiliation(s)
- Christa Smolarchuk
- Public Health Analytics, Alberta Health, Edmonton, Alberta
- These authors contributed equally to this work and share first authorship
| | - Carla Ickert
- Public Health Analytics, Alberta Health, Edmonton, Alberta
- These authors contributed equally to this work and share first authorship
| | - Nathan Zelyas
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada
| | - Jeffrey C Kwong
- ICES, Toronto, Canada
- Public Health Ontario, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
- University Health Network, Toronto, Canada
| | - Sarah A Buchan
- ICES, Toronto, Canada
- Public Health Ontario, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
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5
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Chan D, Lee L, Bancej C. Does the Australian influenza season predict the Canadian influenza season? A qualitative comparison of seasons, 2014-2020. CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2023; 49:494-500. [PMID: 38504877 PMCID: PMC10946586 DOI: 10.14745/ccdr.v49i1112a05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
A commonly held belief by the Canadian media and public is that the Australian influenza season is a fairly reliable indicator of what the Canadian influenza season that follows might be like. However, this claim is not well substantiated with epidemiological evidence. Therefore, the objective of this work was to qualitatively compare the timing of the onset, peak, and intensity of influenza activity, the dominant circulating influenza strains, and the seasonal vaccine and vaccination policies from 2014 to 2020 between Canada and Australia, using a combination of FluNet data and influenza surveillance reports and publications. Across the epidemiological indicators considered, the epidemics between Canada and Australia often differ. While vaccination policies and coverage are similar between the two countries, vaccine composition and vaccine effectiveness estimates also differ. Ultimately, there are many differences and confounding variables between the Australian and Canadian influenza seasons across numerous indicators that preclude the use of the Australian influenza season as the sole predictor of the Canadian influenza season. However, the availability of global surveillance data and robust national and sub-national surveillance data can provide lead time and inform within-season resource and capacity planning, as well as mitigation measures, for seasonal influenza epidemics.
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Affiliation(s)
- Deborah Chan
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, ON
| | - Liza Lee
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, ON
| | - Christina Bancej
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, ON
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Swanson NJ, Marinho P, Dziedzic A, Jedlicka A, Liu H, Fenstermacher K, Rothman R, Pekosz A. 2019-2020 H1N1 clade A5a.1 viruses have better in vitro fitness compared with the co-circulating A5a.2 clade. Sci Rep 2023; 13:10223. [PMID: 37353648 PMCID: PMC10290074 DOI: 10.1038/s41598-023-37122-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/15/2023] [Indexed: 06/25/2023] Open
Abstract
Surveillance for emerging human influenza virus clades is important for identifying changes in viral fitness and assessing antigenic similarity to vaccine strains. While fitness and antigenic structure are both important aspects of virus success, they are distinct characteristics and do not always change in a complementary manner. The 2019-2020 Northern Hemisphere influenza season saw the emergence of two H1N1 clades: A5a.1 and A5a.2. While several studies indicated that A5a.2 showed similar or even increased antigenic drift compared with A5a.1, the A5a.1 clade was still the predominant circulating clade that season. Clinical isolates of representative viruses from these clades were collected in Baltimore, Maryland during the 2019-2020 season and multiple assays were performed to compare both antigenic drift and viral fitness between clades. Neutralization assays performed on serum from healthcare workers pre- and post-vaccination during the 2019-2020 season show a comparable drop in neutralizing titers against both A5a.1 and A5a.2 viruses compared with the vaccine strain, indicating that A5a.1 did not have antigenic advantages over A5a.2 that would explain its predominance in this population. Plaque assays were performed to investigate fitness differences, and the A5a.2 virus produced significantly smaller plaques compared with viruses from A5a.1 or the parental A5a clade. To assess viral replication, low MOI growth curves were performed on both MDCK-SIAT and primary differentiated human nasal epithelial cell cultures. In both cell cultures, A5a.2 yielded significantly reduced viral titers at multiple timepoints post-infection compared with A5a.1 or A5a. Receptor binding was then investigated through glycan array experiments which showed a reduction in receptor binding diversity for A5a.2, with fewer glycans bound and a higher percentage of total binding attributable to the top three highest bound glycans. Together these data indicate that the A5a.2 clade had a reduction in viral fitness, including reductions in receptor binding, that may have contributed to the limited prevalence observed after emergence.
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Affiliation(s)
- Nicholas J Swanson
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, rm W2116, Baltimore, MD, 21205, USA
| | - Paula Marinho
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, rm W2116, Baltimore, MD, 21205, USA
| | - Amanda Dziedzic
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, rm W2116, Baltimore, MD, 21205, USA
| | - Anne Jedlicka
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, rm W2116, Baltimore, MD, 21205, USA
| | - Hsuan Liu
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, rm W2116, Baltimore, MD, 21205, USA
| | - Katherine Fenstermacher
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Richard Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, rm W2116, Baltimore, MD, 21205, USA.
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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7
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Kissling E, Maurel M, Emborg HD, Whitaker H, McMenamin J, Howard J, Trebbien R, Watson C, Findlay B, Pozo F, Bolt Botnen A, Harvey C, Rose A. Interim 2022/23 influenza vaccine effectiveness: six European studies, October 2022 to January 2023. Euro Surveill 2023; 28:2300116. [PMID: 37227299 PMCID: PMC10283457 DOI: 10.2807/1560-7917.es.2023.28.21.2300116] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/21/2023] [Indexed: 05/26/2023] Open
Abstract
BackgroundBetween October 2022 and January 2023, influenza A(H1N1)pdm09, A(H3N2) and B/Victoria viruses circulated in Europe with different influenza (sub)types dominating in different areas.AimTo provide interim 2022/23 influenza vaccine effectiveness (VE) estimates from six European studies, covering 16 countries in primary care, emergency care and hospital inpatient settings.MethodsAll studies used the test-negative design, but with differences in other study characteristics, such as data sources, patient selection, case definitions and included age groups. Overall and influenza (sub)type-specific VE was estimated for each study using logistic regression adjusted for potential confounders.ResultsThere were 20,477 influenza cases recruited across the six studies, of which 16,589 (81%) were influenza A. Among all ages and settings, VE against influenza A ranged from 27 to 44%. Against A(H1N1)pdm09 (all ages and settings), VE point estimates ranged from 28% to 46%, higher among children (< 18 years) at 49-77%. Against A(H3N2), overall VE ranged from 2% to 44%, also higher among children (62-70%). Against influenza B/Victoria, overall and age-specific VE were ≥ 50% (87-95% among children < 18 years).ConclusionsInterim results from six European studies during the 2022/23 influenza season indicate a ≥ 27% and ≥ 50% reduction in disease occurrence among all-age influenza vaccine recipients for influenza A and B, respectively, with higher reductions among children. Genetic virus characterisation results and end-of-season VE estimates will contribute to greater understanding of differences in influenza (sub)type-specific results across studies.
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Affiliation(s)
| | | | - Hanne-Dorthe Emborg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | | | | | | | - Ramona Trebbien
- Department of Virus and Microbiological Special diagnostics, National Influenza Center, Statens Serum Institut, Copenhagen, Denmark
| | | | | | - Francisco Pozo
- National Centre for Microbiology, National Influenza Reference Laboratory, WHO-National Influenza Centre, Institute of Health Carlos III, Madrid, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Amanda Bolt Botnen
- Department of Virus and Microbiological Special diagnostics, National Influenza Center, Statens Serum Institut, Copenhagen, Denmark
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8
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Xie Y, Tian X, Zhang X, Yao H, Wu N. Immune interference in effectiveness of influenza and COVID-19 vaccination. Front Immunol 2023; 14:1167214. [PMID: 37153582 PMCID: PMC10154574 DOI: 10.3389/fimmu.2023.1167214] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/06/2023] [Indexed: 05/09/2023] Open
Abstract
Vaccines are known to function as the most effective interventional therapeutics for controlling infectious diseases, including polio, smallpox, rabies, tuberculosis, influenza and SARS-CoV-2. Smallpox has been eliminated completely and polio is almost extinct because of vaccines. Rabies vaccines and Bacille Calmette-Guérin (BCG) vaccines could effectively protect humans against respective infections. However, both influenza vaccines and COVID-19 vaccines are unable to eliminate these two infectious diseases of their highly variable antigenic sites in viral proteins. Vaccine effectiveness (VE) could be negatively influenced (i.e., interfered with) by immune imprinting of previous infections or vaccinations, and repeated vaccinations could interfere with VE against infections due to mismatch between vaccine strains and endemic viral strains. Moreover, VE could also be interfered with when more than one kind of vaccine is administrated concomitantly (i.e., co-administrated), suggesting that the VE could be modulated by the vaccine-induced immunity. In this review, we revisit the evidence that support the interfered VE result from immune imprinting or repeated vaccinations in influenza and COVID-19 vaccine, and the interference in co-administration of these two types of vaccines is also discussed. Regarding the development of next-generation COVID-19 vaccines, the researchers should focus on the induction of cross-reactive T-cell responses and naive B-cell responses to overcome negative effects from the immune system itself. The strategy of co-administrating influenza and COVID-19 vaccine needs to be considered more carefully and more clinical data is needed to verify this strategy to be safe and immunogenic.
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Affiliation(s)
- Yiwen Xie
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
| | - Xuebin Tian
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
| | - Xiaodi Zhang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
| | - Hangping Yao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
| | - Nanping Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
- *Correspondence: Nanping Wu,
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9
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Rahman S, Hasan M, Alam MS, Uddin KMM, Moni S, Rahman M. The evolutionary footprint of influenza A subtype H3N2 strains in Bangladesh: implication of vaccine strain selection. Sci Rep 2022; 12:16186. [PMID: 36171388 PMCID: PMC9519982 DOI: 10.1038/s41598-022-20179-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/09/2022] [Indexed: 11/09/2022] Open
Abstract
In February each year, World Health Organization (WHO) recommends candidate vaccine viruses for the forthcoming northern hemisphere (NH) season; however, the influenza season in the temperate zone of NH begins in October. During egg- or cell culture-propagation, the vaccine viruses become too old to confer the highest match with the latest strains, impacting vaccine effectiveness. Therefore, an alternative strategy like mRNA-based vaccine using the most recent strains should be considered. We analyzed influenza A subtype H3N2 strains circulating in NH during the last 10 years (2009-2020). Phylogenetic analysis revealed multiple clades of influenza strains circulating every season, which had substantial mismatches with WHO-recommended vaccine strains. The clustering pattern suggests that influenza A subtype H3N2 strains are not fixed to the specific geographical region but circulate globally in the same season. By analyzing 39 seasons from eight NH countries with the highest vaccine coverage, we also provide evidence that the influenza A, subtype H3N2 strains from South and Southeast Asia, including Bangladesh, had the highest genetic proximity to the NH strains. Furthermore, insilico analysis showed minimal effect on the Bangladeshi HA protein structure, indicating the stability of Bangladeshi strains. Therefore, we propose that Bangladeshi influenza strains represent genetic makeup that may better fit and serve as the most suitable candidate vaccine viruses for the forthcoming NH season.
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Affiliation(s)
- Sezanur Rahman
- Virology Laboratory, Infectious Diseases Division, icddr,b, Mohakhali, 68 Shaheed Tajuddin Ahmed Sarani, Dhaka, 1212, Bangladesh
| | - Mehedi Hasan
- Virology Laboratory, Infectious Diseases Division, icddr,b, Mohakhali, 68 Shaheed Tajuddin Ahmed Sarani, Dhaka, 1212, Bangladesh
| | - Md Shaheen Alam
- Virology Laboratory, Infectious Diseases Division, icddr,b, Mohakhali, 68 Shaheed Tajuddin Ahmed Sarani, Dhaka, 1212, Bangladesh
| | - K M Main Uddin
- Virology Laboratory, Infectious Diseases Division, icddr,b, Mohakhali, 68 Shaheed Tajuddin Ahmed Sarani, Dhaka, 1212, Bangladesh
| | - Sayra Moni
- Virology Laboratory, Infectious Diseases Division, icddr,b, Mohakhali, 68 Shaheed Tajuddin Ahmed Sarani, Dhaka, 1212, Bangladesh
| | - Mustafizur Rahman
- Virology Laboratory, Infectious Diseases Division, icddr,b, Mohakhali, 68 Shaheed Tajuddin Ahmed Sarani, Dhaka, 1212, Bangladesh. .,Genomics Centre, icddr,b, Mohakhali, Dhaka, 1212, Bangladesh.
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10
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Jones RP, Ponomarenko A. Roles for Pathogen Interference in Influenza Vaccination, with Implications to Vaccine Effectiveness (VE) and Attribution of Influenza Deaths. Infect Dis Rep 2022; 14:710-758. [PMID: 36286197 PMCID: PMC9602062 DOI: 10.3390/idr14050076] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/15/2022] [Accepted: 09/15/2022] [Indexed: 08/29/2023] Open
Abstract
Pathogen interference is the ability of one pathogen to alter the course and clinical outcomes of infection by another. With up to 3000 species of human pathogens the potential combinations are vast. These combinations operate within further immune complexity induced by infection with multiple persistent pathogens, and by the role which the human microbiome plays in maintaining health, immune function, and resistance to infection. All the above are further complicated by malnutrition in children and the elderly. Influenza vaccination offers a measure of protection for elderly individuals subsequently infected with influenza. However, all vaccines induce both specific and non-specific effects. The specific effects involve stimulation of humoral and cellular immunity, while the nonspecific effects are far more nuanced including changes in gene expression patterns and production of small RNAs which contribute to pathogen interference. Little is known about the outcomes of vaccinated elderly not subsequently infected with influenza but infected with multiple other non-influenza winter pathogens. In this review we propose that in certain years the specific antigen mix in the seasonal influenza vaccine inadvertently increases the risk of infection from other non-influenza pathogens. The possibility that vaccination could upset the pathogen balance, and that the timing of vaccination relative to the pathogen balance was critical to success, was proposed in 2010 but was seemingly ignored. Persons vaccinated early in the winter are more likely to experience higher pathogen interference. Implications to the estimation of vaccine effectiveness and influenza deaths are discussed.
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Affiliation(s)
- Rodney P Jones
- Healthcare Analysis and Forecasting, Wantage OX12 0NE, UK
| | - Andrey Ponomarenko
- Department of Biophysics, Informatics and Medical Instrumentation, Odessa National Medical University, Valikhovsky Lane 2, 65082 Odessa, Ukraine
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11
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Nguyen VH, Roy B. Modelling the Economic Impact of lnfluenza Vaccine Programs with the Cell-Based Quadrivalent Influenza Vaccine and Adjuvanted Trivalent Influenza Vaccine in Canada. Vaccines (Basel) 2022; 10:vaccines10081257. [PMID: 36016145 PMCID: PMC9412987 DOI: 10.3390/vaccines10081257] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/19/2022] [Accepted: 07/26/2022] [Indexed: 12/10/2022] Open
Abstract
In Canada, approximately 12,000 people annually are hospitalized with influenza. While vaccination is the most effective method for reducing the burden of seasonal influenza, the propagation of vaccine virus strains in eggs can result in egg adaption, resulting in reduced antigenic similarity to circulating strains and thus lower vaccine effectiveness (VE). Cell-based propagation methods avoid these alterations and therefore may be more effective than egg-propagation vaccines. We evaluated three different scenarios: (1) egg-based quadrivalent influenza vaccine (QIVe) for individuals <65 years and adjuvanted trivalent influenza vaccine (aTIV) for ≥65 years; (2) QIVe (<65 years) and high-dose QIV (HD −; QIV; ≥65 years); and (3) cell-based derived QIV (QIVc; <65 years) and aTIV (≥65 years) compared with a baseline scenario of QIVe for all age groups. Modelling was performed using a dynamic age-structured SEIR model, which assessed each strain individually using data from the 2012−2019 seasons. Probabilistic sensitivity analysis assessed the robustness of the results with respect to variation in absolute VE, relative VE, number of egg-adapted seasons, and economic parameters. QIVe + aTIV was cost-saving compared with the baseline scenario (QIVe for all), and QIVe + HD − QIV was not cost-effective in the majority of simulations, reflecting the high acquisition cost of HD − QIV. Overall, while the incremental benefits may vary by influenza season, QIVc + aTIV resulted in the greatest reductions in cases, hospitalizations, and mortality, and was cost-effective (ICER < CAD 50,000) in all simulations.
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Affiliation(s)
- Van Hung Nguyen
- VHN Consulting Inc., 95 McCulloch, Montreal, QC H2V3L8, Canada
| | - Bertrand Roy
- Seqirus Canada, 16766 Trans-Canada Hwy Suite 504, Kirkland, QC H9H 4M7, Canada
- Correspondence:
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12
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Shinjoh M, Furuichi M, Kobayashi H, Yamaguchi Y, Maeda N, Yaginuma M, Kobayashi K, Nogayama T, Chiga M, Oshima M, Kuramochi Y, Yamada G, Narabayashi A, Ookawara I, Nishida M, Tsunematsu K, Kamimaki I, Shimoyamada M, Yoshida M, Shibata A, Nakata Y, Taguchi N, Mitamura K, Takahashi T. Trends in effectiveness of inactivated influenza vaccine in children by age groups in seven seasons immediately before the COVID-19 era. Vaccine 2022; 40:3018-3026. [PMID: 35450780 PMCID: PMC8995322 DOI: 10.1016/j.vaccine.2022.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/08/2022] [Accepted: 04/07/2022] [Indexed: 11/16/2022]
Abstract
Background Methods Results Conclusions
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Hisato Kobayashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Yoshio Yamaguchi
- Department of Clinical Research, Department of Infection and Allergy, National Hospital Organization Tochigi Medical Center, 1-10-37 Nakatomaturi, Utsunomiya-City, Tochigi 320-8580, Japan.
| | - Naonori Maeda
- Department of Pediatrics, National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan.
| | - Mizuki Yaginuma
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Pediatrics, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka, Kanagawa 254-0065, Japan.
| | - Ken Kobayashi
- Department of Pediatrics, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishimachi, Kanagawa-ku, Yokohama 221-0855, Kanagawa, Japan.
| | - Taisuke Nogayama
- Department of Pediatrics, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka, Kanagawa 254-0065, Japan.
| | - Michiko Chiga
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo 170-8476, Japan.
| | - Mio Oshima
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo 170-8476, Japan.
| | - Yuu Kuramochi
- Department of Pediatrics, Ota Memorial Hospital, 455-1 Ohshimacho, Ota City, Gunma 273-8585, Japan.
| | - Go Yamada
- Department of Pediatrics, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa-shi, Chiba 272-8513, Japan; Department of Pediatrics, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013, Japan.
| | - Atsushi Narabayashi
- Department of Pediatrics, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013, Japan.
| | - Ichiro Ookawara
- Department of Pediatrics, Japanese Red Cross Shizuoka Hospital, 8-2 Outemachi, Aoi-ku, Shizuoka 420-0853, Japan.
| | - Mitsuhiro Nishida
- Department of Pediatrics, Shizuoka City Shimizu Hospital, 1231 Miyakami, Shimizu-ku, Shizuoka-shi, Shizuoka 424-8636, Japan.
| | - Kenichiro Tsunematsu
- Department of Pediatrics, Hino Municipal Hospital, 4-3-1 Tamadaira, Hino-shi, Tokyo 191-0061, Japan.
| | - Isamu Kamimaki
- Department of Pediatrics, National Hospital Organization, Saitama Hospital, 2-1 Suwa, Wako-shi, Saitama 351-0102, Japan.
| | - Motoko Shimoyamada
- Department of Pediatrics, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama-shi, Saitama 336-0911, Japan.
| | - Makoto Yoshida
- Department of Pediatrics, Sano Kosei General Hospital, 1728 Horigome-chou, Sano-city, Tochigi 327-8511, Japan.
| | - Akimichi Shibata
- Department of Pediatrics, Japanese Red Cross Ashikaga Hospital, 284-1 Yobe-cho, Ashikaga, Tochigi 326-0843, Japan.
| | - Yuji Nakata
- Department of Pediatrics, Nippon Koukan Hospital, 1-2-1Koukan-Dori, Kawasaki, Kanagawa 210-0852, Japan.
| | - Nobuhiko Taguchi
- Department of Pediatrics, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa 220-8581, Japan.
| | - Keiko Mitamura
- Department of Pediatrics, Eiju General Hospital, 2-23-16 Higashiueno, Taito-ku, Tokyo 110-8645, Japan.
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
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Bancej C, Rahal A, Lee L, Buckrell S, Schmidt K, Bastien N. National FluWatch mid-season report, 2021-2022: Sporadic influenza activity returns. CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2022; 48:39-45. [PMID: 35273468 PMCID: PMC8856831 DOI: 10.14745/ccdr.v48i01a06] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Surveillance for Canada's 2021-2022 seasonal influenza epidemic began in epidemiological week 35 (the week starting August 29, 2021) during the ongoing coronavirus disease 2019 (COVID-19) global public health emergency. In the 2021-2022 surveillance season to date, there has been a return of persistent sporadic influenza activity, and the first influenza-associated hospitalizations since mid-2020 have been reported. However, as of week 52 (week ending 01/01/2022) activity has remained sporadic, and no influenza-confirmed outbreaks or epidemic activity have been detected. There has been a delay or absence in several traditional seasonal influenza milestones, including the declared start of the influenza season, marked by a threshold of 5% positivity, which historically has occurred on average in week 47. The 429 sporadic detections reported in Canada to date have occurred in 31 regions across seven provinces/territories. Nearly half (n=155/335, 46.3%) of reported cases have been in the paediatric (younger than 19 years) population. Three-quarters of the cases were influenza A detections (n=323/429, 75.3%). Of the subtyped influenza A detections, A(H3N2) predominated (n=83/86, 96.5%). Of the 12 viruses characterized by the National Microbiology Laboratory, 11 were seasonal strains. Among the seasonal strains characterized, only one was antigenically similar to the strains recommended for the 2021-2022 Northern Hemisphere vaccine, though all were sensitive to the antivirals, oseltamivir and zanamivir. Until very recently, seasonal influenza epidemics had not been reported since March 2020. Evidence on the re-emergence of seasonal influenza strains in Canada following the A(H1N1)pdm09 pandemic shows that influenza A(H3N2) and B epidemics ceased through the 2009-2010 season and second wave of A(H1N1)pdm09, but then re-emerged in subsequent seasons to predominate causing epidemics of higher intensity than in the pre-pandemic seasons. When and where seasonal influenza epidemic activity resumes cannot be predicted, but model-based estimates and historical post-pandemic patterns of intensified epidemics warrant continued vigilance through the usual season and for out-of-season re-emergence. In addition, ongoing population preparedness measures, such as annual influenza vaccination to mitigate the intensity and burden of future seasonal influenza epidemic waves, should continue.
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Affiliation(s)
- Christina Bancej
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, ON
| | - Abbas Rahal
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, ON
| | - Liza Lee
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, ON
| | - Steven Buckrell
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, ON
| | - Kara Schmidt
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, ON
| | - Nathalie Bastien
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB
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14
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Ando S. Effectiveness of the 2019-2020 Influenza Vaccine and the Effect of Prior Influenza Infection and Vaccination in Children during the First Influenza Season Overlapping with the COVID-19 Epidemic. J NIPPON MED SCH 2021; 88:524-532. [PMID: 33692300 DOI: 10.1272/jnms.jnms.2022_89-102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Behavioral changes among Japanese, along with the coronavirus disease 2019 (COVID-19) epidemic, may affect the seasonal influenza epidemic in Japan and change influenza vaccine effectiveness (VE). METHODS This single-center, test-negative case-control (TNCC) study estimated influenza VE in children for the first influenza season (2019/20) to overlap the COVID-19 epidemic in. Effects of prior influenza infection and vaccination in children were assessed for the 2019-2020 season. RESULTS Among 386 children, adjusted VE was significant for influenza A/H1N1 (45.5%; 95% confidence interval [CI]: 2.0-69.7) and influenza B (66.7%; 95% CI: 35.9-82.7). Among patients aged 0-6 years, adjusted VE was significant for influenza A (total: A/H1N1+A/H3N2) (65.0%; 95% CI: 22.2-84.3), influenza A/H1N1 (64.8%; 95% CI: 16.9-85.1) and influenza B (87.4%; 95% CI: 50.5-96.8). No VE was observed in patients aged 7-15 years. Administration of two vaccine doses tended to decrease incidences of influenza A (total) and influenza A/H1N1 in patients aged 0-6 years. The adjusted odds ratios (ORs) of influenza B infection in patients, who had influenza during the previous season, were significantly lower among all participants (0.29; 95% CI: 0.11-0.78) and patients aged 7-15 years (0.34; 95% CI: 0.12-0.94). The adjusted ORs of influenza infections were not significant in patients vaccinated during the previous season. CONCLUSIONS TNCC-based estimates of influenza VE were consistent despite the overlapping COVID-19 epidemic.
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15
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Tadakuma K, Maruyama T, Mori K, Fujiki N. Effectiveness of seasonal influenza vaccine in adult Japanese workers, 2017-2020. Vaccine 2021; 40:621-626. [PMID: 34952756 DOI: 10.1016/j.vaccine.2021.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/01/2021] [Accepted: 12/08/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Previous studies have not estimated vaccine effectiveness (VE) against influenza in the working-age Japanese population. In this study, we determined VE in adult workers at a Japanese company. METHODS We estimated VE based on self-reported data regarding influenza infections and vaccinations in employees of an auto parts manufacturing company during three influenza seasons from 2017 to 2020. VE was estimated as 100% × [1 - odds ratio (the ratio of the odds of being diagnosed with influenza among enrollees with and without influenza vaccination)]. Odds ratios were estimated using logistic regression. RESULTS We included 11,347 worker records [3,592 (2017-18), 3,663 (2018-19), and 4,092 (2019-20)] from employees who had worked with the company throughout each influenza season. The adjusted VE was moderate and significant in the 2019-20 season (VE = 53%; 95% confidence interval [CI] = 30% to 69%) but low or negative and non-significant during the 2017-18 (VE = 28%; 95% CI = -5% to 50%) and 2018-19 (VE = -11%; 95% CI = - 42% to 14%) seasons. CONCLUSIONS Influenza vaccines were moderately effective during the 2019-20 season but showed low or negative effectiveness during the 2017-18 and 2018-19 seasons. Self-reports from worker records can successfully help determine VE against influenza.
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Affiliation(s)
- Kiyoshi Tadakuma
- Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan.
| | - Takashi Maruyama
- Department of Physiology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Koji Mori
- Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Nobuhiro Fujiki
- Department of Ergonomics, Institute of Industrial and Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
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16
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Maltezou HC, Stavros S, Asimakopoulos G, Pergialiotis V, Raftopoulos V, Talias MA, Pavli A, Daskalakis G, Sindos M, Koutroumanis P, Theodora M, Antsaklis P, Kostis E, Stratiki E, Kossyvakis A, Theodoridou M, Mentis A, Drakakis P, Loutradis D, Rodolakis A. Effectiveness of maternal vaccination with quadrivalent inactivated influenza vaccine in pregnant women and their infants in 2019-2020. Expert Rev Vaccines 2021; 21:983-992. [PMID: 34878959 DOI: 10.1080/14760584.2022.2013820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Influenza is associated with an increased risk for serious illness, hospitalization and death in pregnant women and young infants. Our aim was to estimate the effectiveness of a quadrivalent inactivated influenza vaccine (QIV) in pregnant women and their infants during 2019-2020 influenza season. METHODS A QIV vaccine was offered to pregnant women followed in a maternity hospital. Women were contacted weekly during the influenza season and asked about symptoms. Polymerase chain reaction testing in pharyngeal samples was offered to pregnant women and infants with influenza-like illness. A Bayesian beta-binomial model was used. RESULTS We studied 636 pregnant women (406 vaccinated and 230 unvaccinated) and 474 infants (281 of mothers vaccinated in pregnancy and 193 of unvaccinated mothers). Using a Bayesian beta-binomial model, it was estimated that influenza vaccination of pregnant women reduced their logit to develop laboratory-confirmed influenza by -4.2 (95% CI -3,7 -4,7) and the logit of their infants to develop laboratory-confirmed influenza by -4.2 (95% CI -3.6, -4.9). The QIV effectiveness against laboratory-confirmed influenza was 43.5% in pregnant women and 31.4% in infants. CONCLUSION Maternal influenza vaccination with QIV in pregnancy reduced the odds of pregnant women and their infants to develop influenza. CLINICAL TRIAL REGISTRATION www.clinicaltrials.gov identifier is NCT04723771.
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Affiliation(s)
- Helena C Maltezou
- Directorate of Research, Studies and Documentation, National Public Health Organization, Athens, Greece
| | - Sofoklis Stavros
- First Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece
| | - George Asimakopoulos
- First Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece
| | - Vasilios Pergialiotis
- First Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece
| | | | - Michael A Talias
- Healthcare Management Postgraduate Program, Open University of Cyprus, Nicosia, Cyprus
| | | | - George Daskalakis
- First Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece
| | - Michael Sindos
- First Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece
| | - Pelopidas Koutroumanis
- First Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece
| | - Marianna Theodora
- First Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece
| | - Panagiotis Antsaklis
- First Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece
| | | | - Evangelia Stratiki
- Neonatal Intensive Care Unit, Alexandra General Hospital, Athens, Greece
| | - Athanasios Kossyvakis
- National Influenza Reference Laboratory of Southern Greece, Hellenic Pasteur Institute, Athens, Greece
| | - Maria Theodoridou
- First Department of Pediatrics, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas Mentis
- National Influenza Reference Laboratory of Southern Greece, Hellenic Pasteur Institute, Athens, Greece
| | - Petros Drakakis
- First Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece
| | - Dimitrios Loutradis
- First Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece
| | - Alexandros Rodolakis
- First Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece
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Lin P, Jin T, Yu X, Liang L, Liu G, Jovic D, Sun Z, Yu Z, Pan J, Fan G. Composition and Dynamics of H1N1 and H7N9 Influenza A Virus Quasispecies in a Co-infected Patient Analyzed by Single Molecule Sequencing Technology. Front Genet 2021; 12:754445. [PMID: 34804122 PMCID: PMC8595946 DOI: 10.3389/fgene.2021.754445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/10/2021] [Indexed: 11/22/2022] Open
Abstract
A human co-infected with H1N1 and H7N9 subtypes influenza A virus (IAV) causes a complex infectious disease. The identification of molecular-level variations in composition and dynamics of IAV quasispecies will help to understand the pathogenesis and provide guidance for precision medicine treatment. In this study, using single-molecule real-time sequencing (SMRT) technology, we successfully acquired full-length IAV genomic sequences and quantified their genotypes abundance in serial samples from an 81-year-old male co-infected with H1N1 and H7N9 subtypes IAV. A total of 26 high diversity nucleotide loci was detected, in which the A-G base transversion was the most abundant substitution type (67 and 64%, in H1N1 and H7N9, respectively). Seven significant amino acid variations were detected, such as NA:H275Y and HA: R222K in H1N1 as well as PB2:E627K and NA: K432E in H7N9, which are related to viral drug-resistance or mammalian adaptation. Furtherly, we retrieved 25 H1N1 and 22 H7N9 genomic segment haplotypes from the eight samples based on combining high-diversity nucleotide loci, which provided a more concise overview of viral quasispecies composition and dynamics. Our approach promotes the popularization of viral quasispecies analysis in a complex infectious disease, which will boost the understanding of viral infections, pathogenesis, evolution, and precision medicine.
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Affiliation(s)
- Peng Lin
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China.,BGI-Qingdao, BGI-Shenzhen, Qingdao, China
| | - Tao Jin
- BGI-Qingdao, BGI-Shenzhen, Qingdao, China.,BGI-Shenzhen, Shenzhen, China
| | - Xinfen Yu
- Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | | | - Guang Liu
- BGI-Qingdao, BGI-Shenzhen, Qingdao, China
| | | | - Zhou Sun
- Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Zhe Yu
- BGI-Shenzhen, Shenzhen, China
| | - Jingcao Pan
- Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Guangyi Fan
- BGI-Qingdao, BGI-Shenzhen, Qingdao, China.,BGI-Shenzhen, Shenzhen, China
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18
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Influenza vaccine during the 2019-2020 season and COVID-19 risk: A case-control study in Québec. Can Commun Dis Rep 2021; 47:430-434. [PMID: 34737675 DOI: 10.14745/ccdr.v47i10a05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background We carried out a case-control study that examined whether receipt of the inactivated influenza vaccine during the 2019-2020 season impacted on the risk of coronavirus disease 2019 (COVID-19), as there was a concern that the vaccine could be detrimental through viral interference. Methods A total of 920 cases with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (diagnosed between March and October 2020) and 2,123 uninfected controls were recruited from those who were born in Québec between 1956 and 1976 and who had received diagnostic services at two hospitals (Montréal and Sherbrooke, Québec). After obtaining consent, a questionnaire was administered by phone. Data were analyzed by logistic regression. Results Among healthcare workers, inactivated influenza vaccine received during the previous influenza season was not associated with increased COVID-19 risk (AOR: 0.99, 95% CI: 0.69-1.41). Among participants who were not healthcare workers, influenza vaccination was associated with lower odds of COVID-19 (AOR: 0.73, 95% CI 0.56-0.96). Conclusion We found no evidence that seasonal influenza vaccine increased the risk of developing COVID-19.
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19
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HIV self-testing in Ottawa, Canada used by persons at risk for HIV: The GetaKit study. CANADA COMMUNICABLE DISEASE REPORT = RELEVÉ DES MALADIES TRANSMISSIBLES AU CANADA 2021; 47:435-441. [PMID: 34737676 DOI: 10.14745/ccdr.v47i10a06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background The Public Health Agency of Canada estimates that about 87% of persons living with human immunodeficiency virus (HIV) in Canada have been diagnosed, which is well below the Joint United Nations Programme on HIV/AIDS target to have 95% of HIV-positive persons diagnosed. Research has shown that HIV self-testing may help increase such diagnoses, especially among the populations who are most affected by HIV. The objective of the study was to determine the uptake and diagnosis outcomes associated with free HIV self-testing. Methods We developed the first online mailout free HIV self-testing program in Canada and implemented it in Ottawa. This project ran through the website, www.GetaKit.ca. We intended to recruit 150-400 participants over a 6-12-month period, estimating that this number would yield between 0-1 positive test results (expected positivity rate of 0.08%). Results Between July 20, 2020 and April 1, 2021, 1,268 people accessed the GetaKit website and verified their eligibility. In total, 600 persons were eligible and 405 ordered an HIV kit. Of those who ordered a kit, 399 completed a baseline survey. Overall, 71% of these participants were members of HIV priority groups. For test results, 228 persons reported test results, with one being positive, for a positivity rate of 0.24% overall and 0.44% of reported results. These rates exceed that normally observed in Ottawa. Conclusion Self-testing of HIV can be effectively delivered through a website. Such an intervention will also be used by persons with undiagnosed infections and appears to do so at a rate higher than that observed by other means of testing. Self-testing of HIV may therefore help Canada achieve the United Nations 95-95-95 targets.
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Poor Vaccine Effectiveness against Influenza B-Related Severe Acute Respiratory Infection in a Temperate North Indian State (2019-2020): A Call for Further Data for Possible Vaccines with Closer Match. Vaccines (Basel) 2021; 9:vaccines9101094. [PMID: 34696202 PMCID: PMC8540586 DOI: 10.3390/vaccines9101094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/21/2021] [Accepted: 09/21/2021] [Indexed: 01/22/2023] Open
Abstract
Background: Influenza vaccine uptake in India is poor, and scant data exist regarding the effectiveness of influenza vaccine against hospitalization. Methods: From October 2019 to March 2020, vaccination status of 1219 patients (males n = 571, aged 5–107 years; median, 50 years) hospitalized with severe acute respiratory illness (SARI) was assessed. The patients were tested for influenza viruses and their subtypes by RT PCR. Sequencing of the HA gene was performed. Vaccine effectiveness (VE) against influenza subtypes was estimated by the test negative design. Results: A total of 336 (27.5%) patients were influenza-positive, with influenza B/Victoria accounting for 49.7% (n = 167), followed by influenza A/H1N1 (47.6%; n = 155) and influenza A/H3N2 (4.4%; n = 15). About 6.8% and 8.6% of the influenza-positive and influenza-negative patients, respectively, had been vaccinated. Adjusted VE for any influenza strain was 13% (95% CI −42 to 47), which for influenza B was 0%. HA sequencing revealed that influenza B samples mainly belonged to subclade V1A.3/133R with deletion of residues 163–165, as against the 2-aa deletion in influenza B/Colorado/06/2017 strain, contained in the vaccine. VE for influenza A/H1N1 was 55%. Conclusions: Poor VE due to a genetic mismatch between the circulating strain and the vaccine strain calls for efforts to reduce the mismatch.
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21
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Grijalva CG, Feldstein LR, Talbot HK, Aboodi M, Baughman AH, Brown SM, Casey JD, Erickson HL, Exline MC, Files DC, Gibbs KW, Ginde AA, Gong MN, Halasa N, Khan A, Lindsell CJ, Nwosu SK, Peltan ID, Prekker ME, Rice TW, Shapiro NI, Steingrub J, Stubblefield WB, Tenforde MW, Patel M, Self WH. Influenza Vaccine Effectiveness for Prevention of Severe Influenza-Associated Illness among Adults in the United States, 2019-2020: A test-negative study. Clin Infect Dis 2021; 73:1459-1468. [PMID: 34014274 DOI: 10.1093/cid/ciab462] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Influenza vaccine effectiveness (VE) against a spectrum of severe disease, including critical illness and death, remains poorly characterized. METHODS We conducted a test-negative study in an intensive care unit (ICU) network at 10 United States hospitals to evaluate VE for preventing influenza-associated severe acute respiratory infection (SARI) during the 2019-2020 season, which was characterized by circulation of drifted A/H1N1 and B-lineage viruses. Cases were adults hospitalized in the ICU and a targeted number outside the ICU (to capture a spectrum of severity) with laboratory-confirmed influenza-associated SARI. Test-negative controls were frequency-matched based on hospital, timing of admission, and care location (ICU vs non-ICU). Estimates were adjusted for age, comorbidities, and other confounders. RESULTS Among 638 patients, the median (interquartile) age was 57 (44-68) years; 286 (44.8%) patients were treated in the ICU and 42 (6.6%) died during hospitalization. Forty-five percent of cases and 61% of controls were vaccinated, which resulted in an overall VE of 32% (95% CI: 2 to 53%), including 28% (-9% to 52%) against influenza A, and 52% (13% to 74%) against influenza B. VE was higher in adults 18-49 years old (62%; 95% CI: 27% to 81%) than those 50-64 years old (20%, -48% to 57%) and ≥65 years old (-3%; 95% CI: -97% to 46%) (p=0.0789 for interaction). VE was significantly higher against influenza-associated death (80%, 95% CI: 4% to 96%) than non-fatal influenza illness. CONCLUSIONS During a season with drifted viruses, vaccination reduced severe influenza-associated illness among adults by 32%. VE was high among young adults.
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Affiliation(s)
| | - Leora R Feldstein
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - H Keipp Talbot
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Michael Aboodi
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Samuel M Brown
- Intermountain Medical Center and University of Utah, Salt Lake City, Utah, USA
| | | | - Heidi L Erickson
- Hennepin County Medical Center and the University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | | | - D Clark Files
- Wake Forest School of Medicine, Winston Salem North Carolina, USA
| | - Kevin W Gibbs
- Wake Forest School of Medicine, Winston Salem North Carolina, USA
| | - Adit A Ginde
- University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Michelle N Gong
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Natasha Halasa
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Akram Khan
- Oregon Health & Science University, Portland, Oregon, USA
| | | | - Samuel K Nwosu
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ithan D Peltan
- Intermountain Medical Center and University of Utah, Salt Lake City, Utah, USA
| | - Matthew E Prekker
- Hennepin County Medical Center and the University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Todd W Rice
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Nathan I Shapiro
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Jay Steingrub
- Baystate Medical Center, Springfield, Massachusetts, USA
| | | | - Mark W Tenforde
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Manish Patel
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Wesley H Self
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
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22
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Differential Influence of Age on the Relationship between Genetic Mismatch and A(H1N1)pdm09 Vaccine Effectiveness. Viruses 2021; 13:v13040619. [PMID: 33916601 PMCID: PMC8065480 DOI: 10.3390/v13040619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/24/2021] [Accepted: 04/02/2021] [Indexed: 01/02/2023] Open
Abstract
Assessment of influenza vaccine effectiveness (VE) and identification of relevant influencing factors are the current priorities for optimizing vaccines to reduce the impacts of influenza. To date, how the difference between epidemic strains and vaccine strains at genetic scale affects age-specific vaccine performance remains ambiguous. This study investigated the association between genetic mismatch on hemagglutinin and neuraminidase genes and A(H1N1)pdm09 VE in different age groups with a novel computational approach. We found significant linear relationships between VE and genetic mismatch in children, young adults, and middle-aged adults. In the children’s group, each 3-key amino acid mutation was associated with an average of 10% decrease in vaccine effectiveness in a given epidemic season, and genetic mismatch exerted no influence on VE for the elderly group. We demonstrated that present vaccines were most effective for children, while protection for the elderly was reduced and indifferent to vaccine component updates. Modeling such relationships is practical to inform timely evaluation of VE in different groups of populations during mass vaccination and may inform age-specific vaccination regimens.
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23
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Influenza vaccination effectiveness in preventing influenza hospitalization in children, Hong Kong, winter 2019/20. Vaccine 2020; 38:8078-8081. [DOI: 10.1016/j.vaccine.2020.10.081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 10/01/2020] [Accepted: 10/26/2020] [Indexed: 11/18/2022]
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24
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Tsuzuki S, Ishikane M, Matsunaga N, Morioka S, Yu J, Inagaki T, Yamamoto M, Ohmagari N. Interim 2019/2020 Influenza Vaccine Effectiveness in Japan from October 2019 to January 2020. Jpn J Infect Dis 2020; 74:175-179. [PMID: 32999182 DOI: 10.7883/yoken.jjid.2020.177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Herein, we report the interim vaccine effectiveness (VE) of a quadrivalent inactivated influenza vaccine, during the 2019/2020 influenza season, in Japan. We conducted a retrospective observational cohort study of 381 patients aged ≥15 years, who were enrolled with influenza like illnesses and examined via the rapid influenza diagnostic test, at the Ambulatory Care unit of the National Center for Global Health and Medicine in Tokyo, Japan, from the beginning of October 2019 to the end of January 2020. VE was estimated using a test-negative design. VE was calculated as (1 - odds ratio) × 100%, comparing influenza A test positivity between vaccinated and unvaccinated patients. Of the 381 patients initially screened for inclusion, 314 were enrolled in the study. Of these, 105 were vaccinated, 98 were diagnosed with influenza A, and 5 were diagnosed with influenza B. Overall VE against influenza A was 27.6% (95% confidence interval [CI], ‒21.1 to +57.4), and in patients aged ≥65 years, it was 47.3% (95% CI, ‒76.0 to +86.0). This indicates that the influenza vaccination offered continued protection during the 2019/2020 influenza season, but a detailed analysis of more cases with a careful consideration of methodology is necessary to estimate VE more precisely.
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Affiliation(s)
- Shinya Tsuzuki
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Japan.,Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | - Masahiro Ishikane
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Japan.,Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Nobuaki Matsunaga
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Japan
| | - Shinichiro Morioka
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Jiefu Yu
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Japan.,Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Takeshi Inagaki
- General Internal Medicine, National Center for Global Health and Medicine, Japan.,Department of Emergency Medicine and Critical Care, National Center for Global Health and Medicine, Japan
| | - Makiko Yamamoto
- Department of Emergency Medicine and Critical Care, National Center for Global Health and Medicine, Japan
| | - Norio Ohmagari
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Japan.,Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
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25
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Gouma S, Weirick M, Hensley SE. Antigenic assessment of the H3N2 component of the 2019-2020 Northern Hemisphere influenza vaccine. Nat Commun 2020; 11:2445. [PMID: 32415074 PMCID: PMC7229105 DOI: 10.1038/s41467-020-16183-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 04/19/2020] [Indexed: 11/13/2022] Open
Abstract
The 2019–2020 Northern Hemisphere influenza vaccine includes antigens from 3c3.A H3N2 viruses; however, over half of circulating H3N2 viruses belong to subclade 3c2.A1b. Here, we analyze antibody responses elicited by the egg-adapted 3c3.A H3N2 vaccine strain in ferrets and humans. We find that this vaccine strain elicits antibodies that have reduced reactivity to a wild-type 3c3.A strain and very limited reactivity to 3c2.A strains, including the currently circulating 3c2.A1b strain. Vaccine mismatch and changes in antigenicity due to vaccine strain egg adaptation can affect seasonal influenza vaccine effectiveness. Here, Gouma et al. show that the egg-adapted 3c3.A H3N2 vaccine strain elicits antibodies with limited reactivity to a wildtype 3c3.A strain and currently circulating 3c2.A H3N2 strains.
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Affiliation(s)
- Sigrid Gouma
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Madison Weirick
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Scott E Hensley
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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26
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Human Vaccines & Immunotherapeutics: news. Hum Vaccin Immunother 2020; 16:740-741. [DOI: 10.1080/21645515.2020.1747917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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27
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Rose A, Kissling E, Emborg HD, Larrauri A, McMenamin J, Pozo F, Trebbien R, Mazagatos C, Whitaker H, Valenciano M. Interim 2019/20 influenza vaccine effectiveness: six European studies, September 2019 to January 2020. Euro Surveill 2020; 25:2000153. [PMID: 32183932 PMCID: PMC7078828 DOI: 10.2807/1560-7917.es.2020.25.10.2000153] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BackgroundInfluenza A(H1N1)pdm09, A(H3N2) and B viruses were co-circulating in Europe between September 2019 and January 2020.AimTo provide interim 2019/20 influenza vaccine effectiveness (VE) estimates from six European studies, covering 10 countries and both primary care and hospital settings.MethodsAll studies used the test-negative design, although there were some differences in other study characteristics, e.g. patient selection, data sources, case definitions and included age groups. Overall and influenza (sub)type-specific VE was estimated for each study using logistic regression adjusted for potential confounders.ResultsThere were 31,537 patients recruited across the six studies, of which 5,300 (17%) were cases with 5,310 infections. Most of these (4,466; 84%) were influenza A. The VE point estimates for all ages were 29% to 61% against any influenza in the primary care setting and 35% to 60% in hospitalised older adults (aged 65 years and over). The VE point estimates against A(H1N1)pdm09 (all ages, both settings) was 48% to 75%, and against A(H3N2) ranged from -58% to 57% (primary care) and -16% to 60% (hospital). Against influenza B, VE for all ages was 62% to 83% (primary care only).ConclusionsInfluenza vaccination is of continued benefit during the ongoing 2019/20 influenza season. Robust end-of-season VE estimates and genetic virus characterisation results may help understand the variability in influenza (sub)type-specific results across studies.
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Affiliation(s)
- Angela Rose
- Epiconcept, Paris, France,Authors contributed equally to the study and manuscript writing
| | - Esther Kissling
- Epiconcept, Paris, France,Authors contributed equally to the study and manuscript writing
| | - Hanne-Dorthe Emborg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Amparo Larrauri
- National Epidemiology Centre, Institute of Health Carlos III, Madrid, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | - Francisco Pozo
- National Centre for Microbiology, National Influenza Reference Laboratory, WHO-National Influenza Centre, Institute of Health Carlos III, Madrid, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Ramona Trebbien
- Department of Virus and Microbiological Special diagnostics, National Influenza Center, Statens Serum Institut, Copenhagen, Denmark
| | - Clara Mazagatos
- National Epidemiology Centre, Institute of Health Carlos III, Madrid, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | | | - European IVE group
- European Influenza Vaccine Effectiveness (IVE) group members are listed at the end of the article
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